- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $18,657.90 / $30,471.50
| Facility | | $6,303.00 | $18,657.90 | $30,471.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,642.77 / $33,892.26 / $45,476.11
| Facility | | $24,642.77 | $33,892.26 | $45,476.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,190.43 / $27,726.83 / $38,868.47
| Facility | | $20,190.43 | $27,726.83 | $38,868.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,577.59 / $30,793.76 / $38,820.86
| Facility | | $17,577.59 | $30,793.76 | $38,820.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,577.59 / $31,050.10 / $40,715.94
| Facility | | $17,577.59 | $31,050.10 | $40,715.94 |